Provider Demographics
NPI:1235245135
Name:OLIVER, R. SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:R. SCOTT
Middle Name:
Last Name:OLIVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4738
Mailing Address - Country:US
Mailing Address - Phone:781-934-2400
Mailing Address - Fax:
Practice Address - Street 1:41 RESNIK RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4842
Practice Address - Country:US
Practice Address - Phone:781-934-2400
Practice Address - Fax:508-746-3930
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMO0258029A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB39182Medicare ID - Type Unspecified